title: The first report of survival post Rothia aeria endocarditis.
abstract: A 61-year-old patient presented with drowsiness, decreased appetite and weight loss. On examination he had several splinter haemorrhages and a tender mass over the right temporal region. Respiratory and abdominal examinations were unremarkable and heart sounds were normal with no clinically audible murmurs. He spiked regular temperatures and consequently had several blood cultures taken. Transthoracic and transoeseophageal echocardiogram showed a 3 cm mitral valve vegetation. MRI confirmed suspicions of septic emboli in the brain. Blood cultures grew Rothia aeria and he was started on benzylpenicillin, rifampicin and gentamicin. After a period of observation he deteriorated clinically and biochemically, surgical intervention therefore ensued with an urgent metallic mitral valve replacement. Nineteen days postsurgery the patient was successfully discharged on outpatient antibiotic therapy and warfarin. In view of complications such as embolisation and cerebral infarction, R aeria endocarditis should be managed aggressively and with a high index of clinical suspicion.
authors.affiliation: Department of Primary Care, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Arun
authors.initials: A
authors.lastname: Thiyagarajan
authors.forename: Anjella
authors.initials: A
authors.lastname: Balendra
authors.forename: David
authors.initials: D
authors.lastname: Hillier
authors.forename: James
authors.initials: J
authors.lastname: Hatcher
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004269:DNA, Bacterial / Q000032:analysis; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D005500:Follow-Up Studies; D006094:Gram-Positive Bacteria / Q000235:genetics / Q000302:isolation & purification*; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial